Provider Demographics
NPI:1821391871
Name:ENG, NINA J (RD)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:J
Last Name:ENG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BERNICE CT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3218
Mailing Address - Country:US
Mailing Address - Phone:516-719-2325
Mailing Address - Fax:516-719-2328
Practice Address - Street 1:7 BERNICE CT
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3218
Practice Address - Country:US
Practice Address - Phone:516-719-2325
Practice Address - Fax:516-719-2328
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003304-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered